CT-guided 125I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region

Abstract

PURPOSE: We aimed to evaluate the feasibility and clinical effectiveness of CT-guided 125I brachytherapy for distant oral and maxillofacial metastases. MATERIALS AND METHODS: We retrospectively analyzed 65 patients with 84 distant oral and maxillofacial metastases. Thirty-one patients with 38 lesions received 125I brachytherapy (group A) and 34 with 46 lesions received external beam radiotherapy (EBRT; group B). RESULTS: Median follow-up time was 16 months. The 3-, 6-, 12-, 18-, and 24-month local control rates for group A were 83.9%, 75.9%, 66.7%, 38.4%, and 25.0%, respectively; for group B they were 76.5%, 62.5%, 43.8%, 25.0%, and 0.0%, respectively (P < .05); the median local tumor progression-free survival times were 14 and 9 months, respectively. Group A had a better local tumor progression-free survival (LTPFS) relative to group B (P < .001; HR, 6.961 [95%CI, 2.109, 9.356]). Cox proportional hazards regression analysis indicated that 125I brachytherapy, tumor size, and primary pathological type were the independent factors affecting LTPFS. Additionally, 125I brachytherapy showed better performance in relieving patient clinical symptoms relative to EBRT (P < .05). Group A also had fewer complications than group B, especially regarding grade 3/4 complications according to Radiation Therapy Oncology Group grading criteria. Mean overall survival times in groups A and B were 17.1 and 14.8 months, respectively. CONCLUSION: CT-guided 125I brachytherapy is feasible and safe for distant oral and maxillofacial metastases; it achieved a better local control rate, longer LTPFS and fewer complications without compromising overall survival compared with EBRT.

MR‐guided 125I seed implantation treatment for maxillofacial malignant tumor

“…5,23 However, the conventional external beam radiotherapy can seriously damage normal tissues, leading to oral mucositis, hemorrhage, xerostomia, radiation caries and orradionecrosis of the jaws. 11,24 Precision radiotherapy aims to improve radiation curative effects and reduce side effects by targeting lesions with more precise radiation doses and protect normal tissues. The 125 I radionuclide has low photon energy, and a short effective penetration distance in tissues, 25,26 and 125 I is now commonly used as a supplementary therapy for malignant tumors, including lung, rectal, liver, breast, and cervical cancers, osteosarcomas, and others.…”

“…Compared with surgical resection alone, surgical excision plus postoperative radiotherapy can greatly increase oral and maxillofacial malignancy local control and long‐term survival rates 5,23 . However, the conventional external beam radiotherapy can seriously damage normal tissues, leading to oral mucositis, hemorrhage, xerostomia, radiation caries and orradionecrosis of the jaws 11,24 . Precision radiotherapy aims to improve radiation curative effects and reduce side effects by targeting lesions with more precise radiation doses and protect normal tissues.…”

CT-guided 125I brachytherapy combined with chemotherapy for the treatment of unresectable or locally advanced pancreatic carcinoma

“…Iodine-125 ( 125 I) brachytherapy, a treatment as internal radiotherapy, has been considered a useful and minimally invasive modality. It has been shown to be a safe and effective option for many types of tumors such as those on brain, thoracic, prostate and soft tissue (7-10), and remarkable advantage of few complications and side effects (11,12). Under the real-time imaging guidance (CT or ultrasound), the 125 I seed-specific needle is used to insert the seed into the tumor tissue.…”

3D Printed Template CT-Guided 125I Seed Implantation In The Treatment Of A Patient With Giant Type A Thymoma: A Case Report

“…At present, this technique is widely used in China and has achieved good e cacy in the treatment of a variety of solid tumors. Moreover, it has been written into the guidelines for the diagnosis and treatment of prostate cancer of the European Association of Urology (39)(40)(41)(42)(43). In the treatment of thymoma, many articles have reported its effectiveness and safety (8-10).…”